Analysis of TCM deficiency and excess attributes in patients with HBV- related acute- on- chronic liver failure based on phenotype of dendritic cells and function of T lymphocytes

Objective To summarize the traditional Chinese medicine( TCM) deficiency and excess attributes in patients with HBV- related acute- on- chronic liver failure( HBV- ACLF),and to analyze its association with the phenotype of dendritic cells( DCs) and T lymphocyte subsets. Methods The basic information,stages,and TCM syndromes of 30 patients who were diagnosed with HBV- ACLF in The First Affiliated Hospital of Hunan University of Chinese Medicine from March to November,2012 were collected,and according to their deficiency and excess attributes,they were divided into excess group and deficiency group. Ten healthy volunteers were enrolled as the control group. Flow cytometry was used to measure the percentage of CD3+,CD4+,and CD8+T lymphocytes in peripheral blood and the expression rate of CD4+CD25highCD127lowcells,as well as the expression rates of DCs with phenotypes of CD1α,HLA- DR,CD80,CD83,and CD86 which were isolated from peripheral blood mononucleated cells,induced,and cultured in vitro,and its association with TCM deficiency and excess attributes. The t- test was used for comparison of normally distributed continuous data between groups,the Wilcoxon rank sum test was used for comparison of continuous data which were not normally distributed between groups,and the chi- square test was used for comparison of categorical data between groups. Results Compared with the healthy control group,the HBV- ACLF patients showed significant reductions in the percentages of CD3+,CD4+,and CD8+T lymphocytes in peripheral blood and the expression rates of DCs with phenotypes of CD1α,HLA- DR,CD80,CD83,and CD86,as well as a significant increase in the expression rate of CD4+CD25highCD127lowcells( all P < 0. 01). Compared with the excess group,the deficiency group showed significant reductions in the percentages of CD3+and CD4+T lymphocytes and the expression rate of CD4+CD25highCD127lowcells( all P < 0. 05). Compared with the deficiency group,the excess group showed significant increases in the expression rates of DCs with phenotypes of CD1α,CD83,and CD86( all P < 0. 05). Conclusion The HBV- ACLF patients in deficiency and excess groups experience reduced functions of T lymphocyte subsets and insufficient activation function of DCs,which are more obvious in the deficiency group. The immune indices including phenotype of DCs and T lymphocyte subsets can be used as objective reference indices for determining TCM deficiency and excess attributes in HBV- ACLF patients.